Permit (41) CITY OF TIGARD i', ,' I MASTER PERMIT
VSfillia COMMUNITY DEVELOPMENT �►ri'�
Permit#: MST2016-00592
TIGARD 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/16/2017
Parcel: 2S 111 DA20800
Jurisdiction: Tigard
Site address: 8640 SW SCHMIDT LOOP
Subdivision: HERITAGE CROSSING Lot: 27
Project: Heritage Crossing, Lot 27
Project Description: New SF. 10/10/2017: REPRINT to add A/C.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1251 sf Basement: 0 sf Left 5 Parking Spaces:
Height: 35 Bathrooms: 3 Second: 1321 sf Garage: 621 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5 Detectors: Yes
Total: 2572 sf Value: $319,683.03 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0
Bckflw Prevntr: 0 Catch Basins: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Drywell-Trench Drain: 0 Other Fixtures: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: Y Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit . Service Feeder . Temp Srvc/Feeders . Branch Circuits .
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add!500 sf: 5 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener N All
Other: N Other Description: Ecompasing: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF
VB R_3
2572
Owner: Contractor:
DR HORTON INC. DR HORTON INC PORTLAND Required Items and Reports(Conditions)
4380 SW MACADAM AVE STE 100 4380 SW MACADAM AVE SUITE 100 1 Ersn Cntrl 503-639-4175
PORTLAND,OR 97239 PORTLAND,OR 97239
PHONE: 503-222-4151 PHONE: 503-222-4151
FAX: 503-222-1304
Total Fees: $29,927.66
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OARd952-001-0090. You may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
Issued By: ef — , 4.7.-e......_
Permittee Signature: G1,i/ i'9"/'✓/°4/di-770V
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
Mechanical Permit Applic.t, li oEivEn
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Cotitat t!link Emera1d Weeks
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INCITY OF TIGARD MASTER PERMIT
. ' COMMUNITY DEVELOPMENT Permit#: MST2016-00592
T f ,,quo 13125 SW Hall Blvd.,Tigard OR 97223 503.718.2439 Date Issued: 05/16/2017
Parcel: 2S 111 DA20800
Jurisdiction: Tigard
Site address: 8640 SW SCHMIDT LOOP
Subdivision: HERITAGE CROSSING Lot: 27
Project: Heritage Crossing, Lot 27
Project Description: New SF.
BUILDING
Floor Areas Required Setbacks Required
Stories: 2 Bedrooms: 5 First: 1251 sf Basement: 0 sf Left: 5 Parking Spaces:
Height: 35 Bathrooms: 3 Second: 1321 sf Garage: 621 sf Front: 15 Smoke
Dwelling Units: 1 Third: 0 sf Right: 5
Detectors: Yes
Total: 2572 sf Value: $319,683.03 Rear: 15
PLUMBING
Sinks: 1 Water Closets: 3 Washing Mach: 1 Laundry Trays: 0 Rain Drain: 1 Urinals: 0
Lavatories: 4 Dishwashers: 1 Floor Drains: 0 Sewer Lines: 100 SF Rain Storm Sewer: 100
Tubs/Showers: 4 Garbage Disp: 1 Water Heaters: 1 Water Lines: 100 Drains: 0 Catch Basins: 0
Bckflw Prevntr: 0
Footing Drain: 0 Ice Maker: 1 Hose Bib: 2 Backwater Value: 1
Other Fixtures: 0
Drywell-Trench Drain: 0
Other Fixture Units:
MECHANICAL
Fuel Types Air Conditioning: N Vent Fans: 5 Clothes Dryers: 1
Natural Gas Heat Pump: N Hoods: 1 Other Units: 0
Furn<100K: 1 Vents: 0 Woodstoves: 0 Gas Outlets: 4
Furn>=100K: 0
ELECTRICAL
Residential Unit Service Feeder Temp Srvc/Feeders Branch Circuits
1000 sf or less: 1 0-200 amp: 0 0-200 amp: 0 W/Svc or Fdr: 0
Ea add'I 500 sf: 5 201-400 amp: 0 201-400 amp: 0 W/O Svc/Fdr: 0
Mfd Home/Feeder/Svc: 0 401-600 amp: 0 401-600 amp: 0
601-1000 amp: 0 601+amp-1000v: 0
1000+amp/volt: 0
ELECTRICAL-RESTRICTED ENERGY
SF Residential
Audio&Stereo: N HVAC: N Security Alarm: N Vaccuum System: N Garage Opener: N All
Other: N Other Description: Ecompasing: Y
BUILDING INFO
Class of Work: Type of Use: Type of Constr: Occupancy Group: Square Feet:
NEW SF VB R-3 2572
Owner: Contractor:
DR HORTON INC. DR HORTON INC PORTLAND Required Items and Reports(Conditions)
4380 SW MACADAM AVE STE 100 4380 SW MACADAM AVE SUITE 100 1 Ersn Cntrl 503-639-4175
PORTLAND,OR 97239 PORTLAND,OR 97239
PHONE: 503-222-4151 PHONE: 503-222-4151
FAX: 503-222-1304
Total Fees: $29,875.30
This permit is issued subject to the regulations contained in the Tigard Municipal Code, State of OR. Specialty Codes and all other applicable law. All work will
be done in accordance with approved plans. This permit will expire if work is not started within 180 days of issuance, or if work is suspended for more the 180
days. ATTENTION: Oregon law requires you to follow the rules adopted by the Oregon Utility Notification Center. Those rules are set forth in OAR
952-001-0010 through OAR 2-001-0090. Yo may obtain a copy of the rules or direct questions to OUNC by calling 503.232.1987 or 1.800.332.2344.
•
Issued By: //wleee..i ;Gl/"( Permittee Signature: ✓ t `l/i)//CbGL 21
Call 503.639.4175 by 7:00 a.m.for the next available inspection date.
This permit card shall be kept in a conspicuous place on the job site until completion of the project.
Approved plans are required on the job site at the time of each inspection.
i M (3c)
Building Permit Application 4 y, , a ;,i"li, L c ' Q ' '
Residentialo. 1O 011 1C"1 t sl ()NI v'
City of Tigard ,, 1 2..011-,,r, pR,.i. , `) , l!r �'LLS7a !(v —0051u
C i Oatc•[�� .4 Pemut N
', 13125 SW Hall Blvd.,Tigard,OR 97223 Plan Ke.iew
Phone; 503.718 2439 Fax: 503 598.1940;0 bate 13r: 17 Other Permit J QIc 2,
Inspection Line. 503.b394175 "`�
, i,,''-F t z Nate Rohl) lurk See Page 2 for
Internet: www.tigard-or.gos : -; x r NotifiedMedmd.37 / i upplementat Information
TYPE OF WORK REQUIRED DATA:I-AND 2-FAMILY DN ELLING
31 New construction 0 Demolition Permit fees*are based on the value of the work performed.
Indicate the value(rounded to the nearest dollar)of all
0 Addition/alteration/replacement ❑Other: equipment,materials.labor,overhead,and the profit for the
CATEGORY OF CONSTRUCTION work indicated on this application. _
la I-and 2-family dwelling 0 Commercial/industrial Valuation: S IJP+V�`
❑ Accessory building ❑etulti-family Number of bedrooms: :( i JI
❑ Master builder ❑Other: Number of bathrooms. 3
JOB SITE INFORMATION AND LOCATION Total number of floors; 2 316\5
Job site address: 55--C2 11 :SLA,./ c5c r ltcJ t / New dwelling arca: IAS 7� square feet
t�1iV� r
City/State/ZIP:Tigard,OR 97223 Garage.carport arca: (al I square feet +Z
Suitebldg.lapt.no.: Project nano ' Ari- /aJ�. ( 4'C) ) n,I Covered porch area: No square feet 1,
Cross street/directions to job site: ' " Deck area: square feet
Other structure area: square feet
REQUIRED DATA:COMMERC IAL-USE CHECKLIS"C
Subdivision: l Lot no.: 027 Permit fees*are based on the value of the work performed.
Tax map/parcel no.: Indicate the value(rounded to the nearest dollar)of all
equipment,materials,labor,overhead,and the profit for the
DESCRIPTION OF WORK work indicated on this application.
New SFR Valuation: $
Existing building area: square feet
New building area: square feet
t PROPERTY OWNER ❑ TENANT Number of stories:
Name: DR Horton Inc. Type of construction:
Address: 4380 SW Macadam Ave Suite 100 Occupancy groups:
City/State/ZIP: Portland,OR 97239 Existing:
Phone:( 503) 222-4151 Fax:( ) Nev:
0 APPLICANT • CONTACT PERSON BUILDING PERMIT FEES*
Business name: DR Horton Inc.
(Please refer solveuAedaf J
Structural plan review fee(or deposit):
Contact name:Emerald Weeks
- FE..S plan review fee(if applicable):
Address: 4380 SW Macadam Ave Suite 100
City/State/ZIP: Total fees due upon application:
Portland, OR 97239
Phone:(503 )222-4151 x1107 Fax: :( ) Amount received:
E-mail: esweeks@drhorton.com PHOTOVOL fAl( SOLAR PANEL S}STEM FEES*
CONTRACTOR Commercial and residential prescriptive installation of
roof-top mounted PhotoVoltaic Solar Panel System.
Business name: DR Horton Inc. Submit two(2)sets of roof plan with connection details
and fire department access.along with the 2010 Oregon
Address:4380 SW Macadam Ave Suite 100 1 Solar Insudlaiion Specialo•Code checklist. _
t City/State'ZIP: Portland, OR 97239 Permit Fee(includes plan review S180.00
and administrative fees):
Phone:(503 )222-4151 Fax:( ) State surcharge(12%of permit fee): 521.60
CCB lir.: 130859 Total fee due upon application: $201.60
Authorized signature ,. { This permit application expires if a permit is not obtained
t ',,,, - within 180 days after it has been accepted as complete.
Print name: f ' .. F r t 'y _ , i Date:2016 "Fee methodology set by 1 ri-County Building Industry
Service Board.
I:Building.Permits`BUP-RESPcnnitApp.doc 02 24201 1 440-46131(11 02 COM'WEB,
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Niechanical Permit Applicatibtf-
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TYPE OF WORK • („ITSIMIERCIALSC:MEDULE USE CIIE(KLIsT
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Electrical Permit Application I o„z()l 1 , i I „ ()\I 1
City of Tigard Received
DyN°"://4-.57-)Vie 11111„le'
13125 SW Hall Blvd.,Tigard OR 97223 PlanReview -CO SQL
67 Phone: 503.718.2439 Fax: 503.598:1960 •z Date/BY: Other Permit
,, ,.:, Inspection Lite: 503.639.4175 Date Ready/By: rods: 13 See Page 2 for
Internet: www.tigard-oegovNoti6ed+Method Supplemental Rtei Information
TYPE OF WORTS - !TAN*REVIEW
®New construction 0 Addition/alteration/replacement Please check all that apply(submit g sets of plans wietems checked below):
❑Demolition ❑Other: 0 Service or feeder 400 amps or more 0 Building over dune stories.
where the available fault current O Maines and boatyards.
CATEGORY'OF CONSTRUCTION .. exceeds 10,000 snips at 150 volts or ['Floating buitdiags.
❑ 1-and 2-family dwelling ❑Comrnercial/industrial- ❑Accessory building leas to ground,or exceeds 14,000- O Codmaciai-nae ulture'
amps ElMulti-family 0 Master builderfor all other installations. besldJatio
0 Other: OFire pump. 1:1bratallatiar of 75 KVA or
JOB SITE INFORMATION ANS LOCATION ['Emergency system. larger separately derived system.
ClAddition of new motor load of O A","E","1"2","1-3",
Job no.: Job site address: (y G/ 3u1,-,i4 / 10011P or more. occupancy.G�-� �+] li" ❑Six or moresidential units, ❑Reaoational vehicle perks.
City/State/ZIP:'p .•f�j Op, mons O Health-care facilities. CI Supply voltage for more than
J ❑Hazardous locations 600 volts nominal.
Suite/bldg./apt no,. Project name: 'o— ��. -�J\v,,0 ❑semi=Or feeder 600 amps or more.
Cross street/directions to job site: FFA SCHEDULE
nerat9tien I Qtr. I Fee I Total I •
New residential single-or multi=family dwelling unit.
Includes attached garage.
Subdivision: Lot no.:02, 1,000 Sq.R.or less 1 yy 168.54 4
Tax map/parcel no.: Fa add'1500 sq,ft.or portion „„i,(75'' 33.92 1
Limited energy,residential 75.00 2
DESCRIPTION OF WORK • (with above sq.ft)
Limited energy,multi-family
residential(with above sq.ft) 75.00 2
Services or feeders installation,alteration,and/or relocation
200 amps or less 100.70 2
0 PROPERTY OWNER i 0 TENANT 201 amps to 400 amps 133.56 2
Name: 401 amps to 600 amps 200.34 2
• 601 amps to 1,000 amps 301.04 2
Address: Over 1,000 amps or volts 552.26 2
City/Stats/ZIP: Trel d� services or feeders Installation,alteration,and/or
oca
Phone:( ) Fix:(, ) 200 amps or less 59.36 I 1
Owner installation:This installation is being made on property that I own which is riot 201 amps to 400 amps I 125.08 2
intended for sale,lease,rent,or exchange,according to ORS 447,449,670,and 701. 401 amps to 599 amps 68 2
Branch circuits-.new,alteration,or extension,per panel
Owner signature: Date: A.Fee for branch circuits with
0 APPLICANT 1 ❑ CONTACT PERSON above service or feeder fee, 7.42 2
each DR Horton Inc Fee
ranch brancinatit
Business name: B.Fee for blanch circuits without
Emerald Weeks service or feeder fee,first
branch C1 56.18 2
Contact name:
t
Address: 4380 SW macadam Ave Fadd
'1 branch circuit 7.42 2
Miscellaneous(service or feeder not included)
City/State/ZIP: Portland OR 97239 Each manufactured or modular 67.84 i 2
503 L22-4I5I &veiling,service and/or feeder
Phone:( ) I Fax::( ) a Reconnect only 67.84 2
E-mail: Pump or irrigation circle 67.84• CONTRAC7�OR Sign or outline lighting 67,84122
Signal circuit(s)or limited-energy r
Business urine: ��A 14-114—
�4— l c---1-1,'G "y`� panel,alteation,or extension. Page 2 l 2
s(;/� ,.L�_ 4 ri_ h additional inspection over allowable In any of the above
Address: o Li IE-' cc-f'L1 A,4�� - �y /�Cl Additional inspection(1 hr min) 6625/hr
City/State/ZIP: {V`/'rte r c 01/(j/,0 i % 1 �4 .. .l FU b / Indg �(1 hrmm) 76,25/hr
�� �^ Industrial plant(1 ihrs no 78.18)hr
Phone: 5--/f_ Fax: %a) S 596E� Inspections for which no fee is
specifically listed 04 hr min) 90.00/hr
CCB Lie.:/ 2I/,9 Electrical Lic.:.CZ30 Suprv.Lic.: i7?I S • ELECTRICAL PERMIT FEES
Suprv.Electrician signature,required:�V� '" Subtotal:
Print name:Ch Plan review(25%of permit fee):
h
Cc, / -'i6 , , a l:'i'11 : + Date: _ State surcharge(12%of permit fee):
Authorized signature: TOTAL PERMIT kF.b:
Print name: ,,, This permit days after it plication lollres if a been acceptedpedis not pl obtained within 180
�t3Jfo� Date: * Number ofas complete
inspections allowed per permit.
lAlkilding1Permits\ELC-AvmitApii
440.4615TO r/05/COM/w$g
Electrical Permit Application—City of Tigard
Page 2—Supplemental Information
/t4ST,z.U( - Ge z` '
Limited Energy Permit Fees: Renewable Energy Permit Fees:
RESIDENTIAL WORK ONLY: `Y _'� nccri�tioo FEE SCHEn1LE
E T,11Fee for all residential systems combined: $75.00
ReneHable electrical energy systems:
Check Type of Work Involvedz 5 k.a or less 1,; ,
5.01 to 15 kva 133.56ri 2�
Audio and Stereo Systems* 15.01 to 25 kra 200.34
Wind generation systems in excess of 25 kva:
n Burglar Alarm
25.01 to 50 kva 301.04 2
X Garage Door Opener* 50 01 to 1U0 kva 552.2t'
›ioo tAa(fee in aceotcanee 1 —�
with OAR 91s-109-0040) 5i2'2� I
a Heating, Ventilation and Air Conditioning ---�
Solar generation systems in excess of 25 kva:
System* 1 _ a
I ach additional Eva OVL1 25 I ? ;
I
I Vacuum Systems* .1011 k\a—no additional charge ) {I rt
z
Each additional ins.ection over allowable in any of the above:
Other: Each additional inspection i. III
char'ed at an hourly(1 hr min)hrmin66'S hr 1
Inspections 1+tir which no lee is 1111s citicall listed(°- ) r?(L0(1-hr
COMMERCIAL WORK ONLY: ELECTRICAL PERMIT FEES
Fee for each commercial system: $75.00 Subtotal(Enter on Page 1);
(SEE OAR 918-309-0000) umber of inspections allokredper permit
.
Check Type of Work Involved:
❑ Audio and Stereo Systems
B• oiler Controls
C• lock Systems
E Data Telecommunication Installation
n F• ire Alarm Installation
C HVAC
• Instrumentation
L Intercom and Paging Systems
n Landscape Irrigation Control*
fl Medical
• Nurse Calls
C Outdoor Landscape Lighting*
Protective Signaling
Other:
Total number of commercial systems:
*No licenses are required. Licenses are required for all
other installations
1_,Buitditw.Permits C!_C Pamit.kpp UR FRr.a Ra Y I :'.01,
Plumbing Permit Application
Building Fixtures ,!','r) I OR Oil ICE I.St: U\LI
City of Tigard Received
t n 13125 SW Hall Blvd.,Tigard,ORE_,97223 D.wBy: Permit Na.t. s,7._)„.0
6...._66 �
I Phone: 503.718.2439 Fax 50y3,5981960 �eyNe`v Other Permit No.:
F I G,v It a Inspection Line: 503.639.4175 .' . Date Ready/By: Idris id See Pse S for
Internet: www.tigard-or.gov Notified/Method: Ssjplemeawl lafonoatlea
}• . '.,. TYPE OF WORK . . FEL• 13CAEDi1I '.', �.
p New construction 0 Demolition For spedal Information use checklist
❑Addition/alteration/replacement0Ott - Description r t . 1 Ea. I Total
New I-2-family dwellings(includes 100 ft for each utility connection)
CATEGORY OF CONsIRt1rroN SFR(1)bath 312.70
❑I-and 2-family dwelling 0 Commercial/industrial SFR(2)bath 437.78
p Accessory building 0 Multi-family SFR(3)bath 50032
❑Master builder pother Each additional bath/kitchen 25.02
Fire sprinkler(__sq.ft.) Page 2
• JOB•$JEE,pp.o. 4v91l1:'AND LOCATION Site utilities:
Job She address: L1 ^ � , L ) Catch basin or area drain 18.76
( r . 1t/t1 vc�11:�1 " 1� Drywetl,leach line,or trench drain 18.76
City/State/ZIP: " ,(L G)1- 7 T> -
t' Footing drain(no.linear ft.: ) Page 2
Suite/bldgJapt.no.: Project name: d �`)1/� Manufactured home utilities 50.03
Cross street/directions to job site: j Manholes 18.76
Rain drain connector 18.76
Sanitary sewer(no.linear ft.:__) Page 2
Storm sewer(no.linear ft.:_-__) Page 2
Water service(no.linear ft.:„-___) 1 Page 2
Subdivision: Lot no.: •-7 Fixture or item:
Tax map/parcel no.: Backflow preventer 31.27
. . DESCRIPTION OF:WORK Backwater valve 12 51
Clothes washer 25.02
Dishwasher 25.02
V Drinking fountain 25.02
Ejectors/sump 25.02
CI PRtirti ! OVNNER . • -I . p TENArrr Expansion tank 12.51
Name. �
E�f C.^�._ U v',� U \ Fixture/sewer cap 25.02
Floon
Address. `-\� <-� \ n.0`G+ Garbage drsoor sink/hub 25.02
C�� 71 disposal 25.02
City/State/ZIP: ,)Q„ Di_ �1Hose bib 25.02
Phone:) t"1\ ...k.4,\ \ Fax:( ) Ice maker 12.51 -1
a
[] Interceptor/grease 0 CONTACT PERSON 8 trap
25.02
Business name: 3)V___ `'\4 + 'VN.C. Medical gas(value:S_i) Page 2
�iNALVv 1 CA \JO- n ofd 12.51
Conrad name: -•� , Sx Roof drain(commercial) 12.51
Address: Sink/basin/lavatory 25.02
City/State ZlP: Solar units(potable water) 62.54
Phone:( ) / Fax:
VFax::r:( ) Tub/shower/shower pan 12.51
E-mail: e��V 5 (VVI Vt . CC ►' t Urinal 25.02 1
Water closet 25.02
;CONTRACTOR
Water heater 37.52
Business name:EDWARD MULLEN PLUMBING Water piping/DWV 56.29
Address:1601 SE RIVER ROAD
Other: 25.02
City/State/ZIP:HILLSBORO,OREGON 97123 Subtotal
Phone:(503)640-0113 Fax:(503)640-4483 Minimum permit fee: 572.50
CCB Lic.:94689 Plumbing Lic.no.:34-260PB Plan review (25%of permit fee)
State surcharge(12%of permit fee) .-----
Authorized signature: Al !' _ TOTAL PERMIT FEE
Print name:RAY MULLEN l Date: This permit application aspires if a permit is sot obtained within lad days
after it has been accepted as complete.
'Fee methodology set by Tri-Cowry Building Industry Service Board.
tosuataeoreroito.mu-MwNAop.oce 10101109 44e•1416Ti10/e2/COMAVES)
City of Tigard
II/ v COMMUNITY DEVELOPMENT DEPARTMENT
1
•
T 1 c a ti D Building Permit Review - Residential
Building Permit #: ///L S 7--).p/, DO C,-2._
Site Address: CS1o4U S .,, l(lin ltat" twp
Project Name: hrrlfiZ44t Or[1 fl Lot #: 2--
(New dwelling ubdivision name; d tion or Alteration=last name of owner)
Planning Review
Proposal: Now S
J(Verify site address/suite# exists and active in permit system.
.. 1"-River Terrace Neighborhood: No El Yes,See River Terrace Review Addendum Attached
Site Plan Elements:
N ree(3)copies of site plan Existing structures on site
l.ite plan must be on 8-1/2"x 11"or 11 x 17"paper Footprint of new structure(including decks)with finished
D rawn to scale(standard architect or engineer scale) floor elevations
orth arrow Utility locations (required for new,may apply for additions)
_J Site address,project or subdivision name and lot number location of wells/septic systems
r Applicant information(name and phone number) xisting trees to be retained with drip line,and tree
. Lot dimensions and building setback dimensions protection measures
XLot area,building coverage area,percentage of coverage and .Street tree size,type and location
impervious area(applicable if R-7,R-12,R-25&R-40) ,Street names
,Property corner elevations(2 foot contour lines if more than
4 foot differential)
51, Clean Water Services—Service Provider Letter(lot platted prior to 9/10/1995):
Required: ❑ Yes,applicant was notified .-E No Received: ❑ Yes ❑ No
Public Facilities Improvement(PH) Permi
Required: ❑ Yes,applicant was notified .10 No Applied For: ❑ Yes ❑ No,stop intake
Land Use Case#: VUL l
Zoning:
:i Required Setbacks: Frot 1,,C.; Rear 6 Side 5 Street Side No. Garage 9,0
s Landscape Requirement: t
Lot Coverage Maximum:
Building Height: Maximum Height Actual Height 2
_Visual Clearance
Ar Easements
Sensitive Lands: ❑ Yes No Type
NI Urban Forestry Plan
. Conditions "Met"prior to issuance of building permit ��
Notes: NMI-nuns ,s1,7,1[t nor* prior 1 U t.,o1,il e
Approved By Planning: tiii.A i "�, r' Date: I , r
Revisions (after Building Submittal onl, Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
1:\Building\Forms\B1dgPermitRvw_RES 091216.docx
Building Permit Submittal
Original Submittal Date: `L /1/f
Site Plans: # 3
Building Plans: # 3
Building Permit#: nter building permit#above.
Workflow Routing: Tanning ylkoEngineering :7"Permit Coordinator -Building
Workflow Sign-off: Sign-off for Itanning(include notes from planning review)
Route Application Documents: Engineering: (1) copy of permit application, (1) site plan, (1) building plan and
original plan review routing form.
Building: original permit application, site plans,building plans, engineer and
beam calculations and trust details,if applicable,etc.
Notes:
By Permit Technician: AL: ,Ili --AN_" Date: /2/L7
Engineering Review
Slope at building pad: /i;
Conditions "Met"prior to issuance of building permit
Easements (encroachments)per engineering conditions of approval and plat
Water Quality/Quantity Facility:
Assess Water Quality Fee in-lieu: ❑ Yes No
Assess Water Quantity Fee in-lieu: ❑ Yes No
LIDA Facility on lot: ❑ Yes No
❑ NOT Approved by Engineering: Date:
Notes:
Approved by Engineering: 14 r Date:
Revisions (after Building Submittal only) Reviewer Date
Revision 1: ❑ Approved ❑ Not Approved
Revision 2: ❑ Approved ❑ Not Approved
Revision 3: ❑ Approved ❑ Not Approved
Permit Coordinator Review
❑ Conditions "Met"prior to issuance of building permit
❑ Approved,NOT Released: Date:
Notes:
Revisions (after Building Submittal only)
Revision Notice 1: Date Sent to Applicant:
Revision Notice 2: Date Sent to Applicant:
Revision Notice 3: Date Sent to Applicant:
DC Fees Entered: Wash Co Trans Dev Tax: Yes ❑ N/A
Tigard Trans SDC: Yes ❑ N/A
Parks SDC: Yes ❑ N/A
OK to Issue Permit
Approved by Permit Coordinator: I Date: o?/7/40'
I:\Building\Forms\BldgPermitRvw_RES 091216.docx
Plumbing Permit Avnlicatiqa
Building Fixtures HEGEIVEr) 1 0.:
City of Tigard Received
IN
unety: 77(0/(7 y Petinitt,./4rS7-d-o/6- .A- 2__._- 13123 SW Hall Blvd.,Tigard.OR-04;hG 8 2017
Plot Review
..._.., i. Phone:.503/18:2439 Fax: 502 (% Dasetey: .0thei Faille No.:
Inspection Line: 503.639.41.75 L., OF TIGARD bate Reedy/By: Mit ta Sonar 2 ter
Internet: www,ligard-or.gova I ill nINGDivlsIV :.„-tNI Notified/Method: Supplemernaklaformatton
-
TYPE OF WORK 1M.E* SCHEDULE
0 New construction 13 Demolition For special itaformildion Use Medd*
Daseripticai I Qty. _I Ea. j Total
ID Addition/alteration/replacement 0 Other: New 1-2-family dwellings(includes 100 fl.*each utility connection) '
CAIII.CeORY'OF CONfiliOCTION SFR(1)bath 312.70
. .
C1 I-and 2-family dwelling 0 Commercial/industrial SFR 121 bath 437.78
SFR(3)bath 500,32
0 Accessory building 0 Multi-family •
Each additional bath/kitchen 25.02
0 Master builder CI Other:
Fire SKinkler( sq.IL) Page 2
, . .
SfrE milionigooN Am LocATio' site mow%
,
Job slte addreer.6 Li/ ,,,,kti,..).. , -1.--Arsiiyvi k 6 .-i-- Catch basin or area(train
,
ki k...
Litt,' OryWeii.leach line,or trench dmin
City/State/ZIP:
. 4 Footing drain(no,linear it: ) Page 2
Suite/WV*.nu.: I Project name': V\CVN11.V y., 0A4)bc---)i(4 anufactured borne utilities 50.03
Crossainsodditectians lojob Site: 'holes 1176
'n drain COnneetor 15.76
Sanitary sewer(no.'linear ft.:._) Page 2
Storm sewer(no.linear ft.: ) Page 2
. Water service(no.Hitter it.:_J Page 2
Subdivision: 1 Lot no.://:4" Fixtare,r Be*:
Tax map/parcel no.: Beek How preventer 31.27
. . ,
DESCRIPTION,OF.WORK - ., BacksVatervejse 12.51
Nev. -OW 6tiltliti' ''..e..) , Clothes washer
C)
Dishwasher
Drinking fountain . 25.02
25.02
25.02
Fjectorsiseinp 25.02
...,. _
_ _____
1111PflFrvV/WPTIII ' * .. 1* , .. "-CI TENANT ExPtelsiert tank 12.51
.
iganie: V-AZ kViv--k-vY1 Mature/sewer tap 25.02
. i
f,....., Floor dmintfloOr sinkihub 25.02
Ai4dItss; Lk/b 1 ' 5-N.‘ .3 %\./V61,C O(
City/State/ZIP: iftW,W .Gathage disposal 25.02
%)(, 2.-• c'n/, 1.10Se bib 25.02
Phone ?) '4..-Li i 5‘ Fax:1 ) . let maker 12.51'
...
. :
Ii iiiiiii441T ,:,, ., .•:• , . cl,cogrAer 0100144 . Interceptor/grease trap 25,02
Business namc: Medical gas(value:S. ) , Page 2
Contact mune: -'*VPk.-VIA te-A \u-ti...trh Primer
Roof drain(commercial) 12.51
12.51
Addrism:
Sinktbasin/lavatory 25.02
City/State/4P: Solar links(potable water) 62:54.
Phone:( ) Fax::( ) Tub/shower/shower pan 12.51
E-mail: Urinal 25.02
tONTRACTOR . Water closet 25.02
Water heater 37.52
Business name:Wolcott Plumbing
WOW'0iPief/DWV 56.29
Addmss:1075W.Historic Columbia River liwy Other; 25.02
City/State/ZIP:Troutdale Or.9060 Subtotal
Phone:(503)667-1781 Fax:(503)6614891 _ Minimum permit fee: $72.50
Plan review(254fee)
(LB Lic.:112220 Plumbing 1.inof permit
.no.:26-824P8 -
k - ,),
State surcharge(12%of permit fee)
Authorized signatur (
TOTAL PERMIT FF.L
Print name:Mt*Ralente Date:V17117 Thin permit application Makes ire permit is not obtained within 180days
after a hos Item accepted as complete..
'Tee methodology et by Tri-Catan Building Industry Servece Boat
I kfluildinehrmitOLM13-ParmitApp.doc 1010M.19 44(1,461.oliialaCintieWRI)
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8640 SW SCHMIDT LOOP, TIGARD, OR, 97224 November 30, 2017 at
10:18:35 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00592
Inspection Type: Inspector:
199 Electrical final Aaron Cillo-Gobel
Result:
PASS
Comments:
Corrections completed.
A/C installed
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8640 SW SCHMIDT LOOP, TIGARD, OR, 97224 November 30, 2017 at
10:19:44 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00592
Inspection Type: Inspector:
399 Plumbing final Aaron Cillo-Gobel
Result:
PASS
Comments:
Corrections completed
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8640 SW SCHMIDT LOOP, TIGARD, OR, 97224 November 30, 2017 at
10:05:26 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00592
Inspection Type: Inspector:
699 Mechanical final Aaron Cillo-Gobel
Result:
PASS
Comments:
Corrections completed.
A/C installed
Violation Summary:
Inspector Contractor
City of Tigard
13125 SW Hall Blvd.
Tigard, OR 97223 Tel: 503.718.2439
Location: Inspection Date:
8640 SW SCHMIDT LOOP, TIGARD, OR, 97224 November 30, 2017 at
10:21 :57 AM
Record Type: Record ID:
Residential - Master Permit MST2016-00592
Inspection Type: Inspector:
299 Final inspection Aaron Cillo-Gobel
Result:
PASS - CofO
Comments:
Final erosion control passed
Street tree certificate received
Moisture content form received
High efficiency lighting form received
Insulation certification verified
Blower door and/or duct seal test certificate received
C of 0 left on counter.
Violation Summary:
Inspector Contractor